April 10, 2020 Webcast Qs&As

Our BAO bereavement sector licensees came out in force, 2,121 of them, for a webcast on April 10 with CEO/Registrar Carey Smith.

Here are answers to questions, not already included in the presentation nor in our previous Qs&As.

Q1. Where can we get more personal protective equipment (PPE)?

A1. The government is working hard on this. Ensure you are using your Personal Protective Equipment effectively and not wasting it unnecessarily. Use N95 masks only on people who require it. You should continue to try and source PPE via your usual channels and ensure you have a suitable quantity of PPE.

Q2. Does the one-hour removal time, of the deceased, apply to private residences?

A2. The Expedited Death Response does not apply to deaths at private residences. The one-hour time applies to hospitals, and three hours or less at long-term-care (LTC) facilities. Just as before, a person who dies at home should be removed in a timely manner.

Q3. Can funeral home or transfer service staff open the body pouch at the hospital or long-term-care (LTC) home to confirm the identity of the deceased?

A3. No. You may rely on the identification tag on the body pouch received at the designated waiting area at the hospital or LTC facility. To reconfirm the identity of the deceased once back at your facility, check all identification tags including those directly on the deceased.

Q4. What happens when a family doesn’t know which funeral home to use?

A4. The Expedited Death Response Team (EDRT) has been instructed to try to obtain funeral home preference on admission to the hospital as well as at the time of death. If families don’t choose, the EDRT will have to make that decision. It’s all about moving as quickly as possible to remove the decedent from the hospital to avoid body storage problems and transfer to the funeral professionals.

Q5. When a person dies of COVID-19, will the cause of death be labelled on the body bag?

A5. Yes. The body pouch will be labelled, by hospital staff, as COVID-19.

A6. If a facility/institution requires the two staff, you must follow their policies. If they do not have a restriction mandating two people at transfer, then you may go with one – but only if it is safe to do so.

Q7. Do crematoriums have to be available 24/7 as funeral homes and cemeteries are required to?

A7. Crematoriums are expected to adjust their operations to be available when needed in order to avoid body storage problems and to prevent delays in cremations.

Q8. Embalming of COVID-19 deceased, or when the virus is suspected, should we continue to provide this option?

A8. Yes. Please also discourage open caskets and family touching the decedent. Please also note that burial, cremation or hydrolysis disposition must take place as soon as possible during the pandemic.

Q9. Due to the State of Emergency situation will you be providing a message for the general public to be in a state of preparedness with their next of kin, funeral home preference, disposition, and notice of 10-person maximum?

A9. Yes. We have been making our COVID-19 information public since February, through our website, Qs&As on the website, social media and many news media interviews with the CBC, The Globe and Mail, Toronto Star, Global TV and several local media organizations. Please also advise family members of the regulations as posted on the BAO’s website. We know this is very difficult for families.

Q10. Does the 10-maximum directive apply to the entire cemetery or is it per burial?

A10. The maximum is 10 people, or fewer. But some cemeteries may have more rigid restrictions. A few cemeteries are now closed to the public and are simply doing the burials without mourners present, which is their right.The max-10 directive rule also encourages funeral homes and cemeteries to be more strict and have fewer people exposed to possible infection in funeral homes and cemeteries.

Q11. For Jewish funeral homes, are they expected to operate 24/7 even during high holidays and Shabbat?

A11. All funeral homes must remain available to respond 24/7 when needed during this pandemic.

Q12. Are municipalities going to be ordered to accept a Statement of Death with an electronic signature?

A12. Yes. We understand that they have been notified of the change in process by the Deputy Registrar General, Vital Statistics Act. Municipalities can use electronic means to receive Form 15 & 16 to obtain a burial permit. Communicate with your local divisional registrar/clerk to confirm that they are equipped to do this. Documents with ink signatures must be delivered to the municipality at least once a week.

Q13. Is there any concern transferring two deceased or more at one time, if your vehicle is capable?

A13. You can transport two or more deceased in one vehicle at the same time as long as the dignity of the deceased is maintained.

Q14. Our local municipality is not using the temporary measures for registering deaths as outlined Office of the Registrar General’s (ORG) April 6, 2020 memo. i.e. electronic/fax filing. What is my recourse?

A14. If you have any questions or concerns, please contact the program’s Team Lead at 807-343-7612. Keep in mind that although municipalities have the authority to transact electronically, they may not have the ability. Many municipal clerks are working from home and may not have the technology.

Q15. If the Medical Certificate of Death (MCOD) isn’t provided when doing the removal, how can I get it?

A15. The MCOD can be obtained electronically through the Ontario Chief Coroner (OCC) Team by emailing occteam@ontario.ca or by calling 1-833-915-0868or 647-792-0440.

Q16. With the state of emergency and 24/7 expectations can we expect to receive ODSP/OW approval within the same 24/7 timing to avoid delay in disposition?

A16.Before the need arises, you are urged to contact your local ODSP/Ontario Works Office now to determine the best course of action for obtaining approvals. We are not aware that they will be available 24/7.

Q17. Due to shortage of PPE, including body pouches: What would you recommend for transfers from long-term care facilities (LTC) under the Expedited Death Response system if we do not have available body pouches?

A17. If you are unable to obtain body pouches from your regular supplier, you are urged to work with LTC facilities or other providers in your community to obtain supplies from wherever possible.

Q18. Does the time clock start when we receive call or when we receive go ahead that medical certificate is ready?

A18. The time starts when you receive the call from the Expedited Death Response Team (EDRT).

Q19. How do we handle a situation where a hospital/LTC is not adhering to these new protocols?

A19. Contact the OCC Team by emailing occteam@ontario.ca orby calling 1-833-915-0868 or 647-792-0440.

Q20. Are hospices and retirement homes included in the expedited response plan?

A20: Not at this time. Hospices generally have clinicians available who can supply a Medical Certificate of Death quickly.

Q21. If the family does not know who the executor is or if the executor is unavailable, is the funeral home protected legally if they transfer based on EDRT directives or next of kin?

A21. Funeral professionals can rely upon the information received from the Expedited Death Response Team and the family contact for the purposes of the initial transfer.

Q22. Should stretchers have all covers removed, or can they be used after the pouch has been disinfected?

A22.Because the fabric cannot be easily disinfected, stretcher covers should not be used. Once the cover is removed disinfect the stretcher.

Q23. Does each and every long-term care (LTC) deceased individual require a body pouch, or only COVID positive cases?

A23. Yes, every death taking place in LTC requires the use of a pouch.

Q24. How can we be certain that the staff at hospital or LTC will be using proper identification procedures?

A24. It’s your responsibility to reconfirm the identity of the deceased by checking all tags/bracelets upon return to your facility. As usual, you may also take this opportunity to remove any jewellery on the deceased for return to the family.

Q25. How can we be certain the staff at the hospital will be using a bleach solution to wipe down body pouches?

A25. Hospital staff have been given instructions to do so. You may inquire whether it has taken place before receiving the body. You should disinfect the pouch again prior to loading the deceased into your vehicle.

Q26. If we have a company policy to allow only 5 max in the funeral home, and the family sees on the BAO website that 10 is the max, will the BAO support the funeral home and inform the family that the funeral home can establish its own policy?

A26. The 10-max-or-fewer directive is a maximum. Funeral homes may go lower than 10 people in the funeral home (not counting FH staff), and in fact the BAO encourages you to do so.

Q27. Can the cemetery contract pallbearers and add it to their opening and closing costs?A27. The cemetery may offer pallbearer services for a fee. However, it must be optional and must be clearly described on its price list. It is a separate cost from the opening and closing price.

A28. This measure is in place to reduce the risk of exposure to you, and to prevent the spread of the virus to others within the LTC facility and/or to your facility.

Q29. Are hospitals/LTCs staff removing jewelry from the deceased?

A29. You may request the Expedited Death Response Team to arrange that jewelry be removed prior to receiving the deceased.

Q30. Due to expedited burial requirements, will cemeteries be required to waive their Saturday and holiday surcharges?

A30. They should not charge their weekend and holiday surcharges to do burials on Saturdays or Sundays during the pandemic. The Registrar has ordered the 24/7 burials, to prevent stockpiling, so families should not have to pay the surcharge.

Q31. Does the one-hour turnaround time for hospitals, and three-hour turnaround from long-term care (LTC) facilities, still apply when it occurs in the middle of the night?